Name _________________________________
Address _______________________________
City __________________ State ____ Zip _____
Telephone _____________________
E-Mail Address ___________________________

Division Entered:
Amateur _______ Proficient Amateur _______
Category Entered:
Color _____ Monochrome ______
Entry Title ______________________________
Sale Price or NFS ___________

___ Will pick up at the Renaissance Center Gallery
___ Private carrier return

I understand this is a juried salon and all photographs may not be shown. Even though I am entering the competition, my work may not be chosen for exhibit. I will not hold the Salon host responsible for damage or loss of an entry.

Signature ____________________ Date ________